Saturday, January 26, 2013

The billion dollar healthcare IT opportunity which the US government wasted

I had a very interesting conversation with a physician who is the chief medical information technology officer for a large hospital chain in the USA. What he revealed was quite eye-opening .

As we all know, the big problem with EMRs ( electronic medical records ) today is that they have not been enthusiastically adopted by doctors. This is not because doctors are luddites – it’s just that EMRs are not doctor-friendly , because they have not been designed by physicians, or for physicians . They have been developed by engineers, and are usually just after- thought add-ons to practice management systems . While they are great for fulfilling the bureaucratic purpose of tracking revenue, doctors dislike them because they disrupt their clinical workflow . The situation is quite a mess – and the government is having to bribe doctors with thousands of dollars in order to get them to adopt EMRs !

It’s going to take a long time before companies get their act together and start responding to physician feedback. Rather than trying to make systems which work for doctors, companies have been trying to retrain doctors to work with their software ! Doctors are smart guys, and are happy to adopt tools which will help them to improve their productivity and efficiency. However, expecting them to unlearn all their clinical skills just because they have to use a badly designed piece of software as commanded by the powers-that-be is wishful thinking,

His point was that for many years the US VA healthcare system has been using an excellent electronic medical record called Vista . The US government should have released Vista as open –source, and made this the de facto standard for all electronic medical records. This would have become the basic platform on which private companies could add bells and whistles, so that physicians could customize it for their own personal needs . This way , the basic electronic medical record would be given away free to everyone who wanted it; and people who then wanted additional features could pay for them. This would combine the best of all possible worlds , because it would ensure that everyone would use a free time-tested working system, which was robust and physician-friendly. It would form a stable backbone , which would also allow tinkering and tweaking as time went by, because the source code would be freely available.

It's such a shame that the US government missed this opportunity . Unfortunately, this is now going to cost doctors and patients billions of dollars and thousands of frustrated wasted man-hours, while we try to make electronic medical records more patient friendly and more physician friendly